Potomac Healthcare Solutions, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

S4081867 Issued in VA

Legal business name

POTOMAC HEALTHCARE SOLUTIONS, LLC

Practice address

1549 Old Bridge Rd Ste 201
Woodbridge, VA 22192-2737

Phone

(703) 498-2773

Fax

(703) 542-1772

NPI assigned

Jun 12, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daphney Jackson

Title

Credentialing Manager

Phone

(703) 498-2773

Specialties & licenses 2

Addresses

Locations

Interoperability endpoints

• Direct secure messaging: drwade@longwoodphs.azalea.phimailbox.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert C Wade, MD

  • Family Medicine Physician
  • Farmville, VA
  • NPI 1154309334
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1477934727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1549 OLD BRIDGE RD STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922737",
            "telephone_number": "703-498-2773",
            "fax_number": "703-542-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1549 OLD BRIDGE RD STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922737",
            "telephone_number": "703-498-2773",
            "fax_number": "703-542-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC HEALTHCARE SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DAPHNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "703-498-2773"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "VA",
            "license": "S4081867",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": "S4081867",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Potomac Cobbler, Inc
• Potomac Dental Care PC
• Potomac Eye Care, PLLC
• Potomac Festival Urgent Care
• Potomac Health Pharmacy LLC
• Potomac Home Care LLC
• Potomac Hospital
• Potomac Hospital
• Potomac Hospital Corporation of Prince William
• Potomac Hospital Corporation of Prince William

• All providers in Woodbridge, VA
• Health Service Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.